I have a very special and painful case I need help with, I have tried several different veterinarians with no diagnosis or prognosis so far. It may be a long shot, but I was hoping you could help me shine a light on this.

In April I found an extremely skinny stray cat and took him in. I first thought he was malnourished from lack of food for being in the streets, but 4 months in his case keeps unfolding.

He is likely older than 15 years old, but he’s a happy cat with a lot of energy and mobility. He weighs 3kg but he’s a big cat, you can feel every single bone in his spine, although you can’t see them that easily because he has long hair. He’s completely affectionate, loves to be pet, and asks very politely for attention and food all the time.

All we know about his past is he is neutered, he had some teeth surgically removed and he tested negative for FIV and FeLV.

He had a huge appetite when I first took him in, he would eat 100g of food in one meal and ask for more right after. He would sometimes ‘cough’, it sounded like he was choking on some kind of fluid, it doesn’t happen in sequences, but it happens almost every day until today.

He always drank LOTS of water and produced a lot of urine as well. His feces at the beginning were really solid with some mucus.

After a month, he continued to eat plenty and hadn’t gained any weight, that’s when he started to throw up. It started happening a few days a week, usually after spending several hours without eating he would throw up a clear frothy fluid with no content, and then it progressed to twice every day regardless of when he had eaten.

We suspected it could be diabetes or hyperthyroidism, but the labwork didn’t confirm either, it showed regular kidney function with small liver function alterations.

We then introduced prednisolone (2,5mg/day) and changed his diet from a mix of natural home-cooked protein, hypercaloric wet food, protein supplements, and dry food to exclusively Royal Canin Hypoallergenic while waiting for Royal Canin Gastrointestinal Hydrolyzed Protein to arrive in Brazil, keeping Omega 3 (fish oil) 500mg/a day in his diet.

Vomits went away for a while. He kept drinking lots of water and peeing a lot, but his feces got softer (not liquid).

He had periods where he lost his appetite, which we treated with mirtazapine, he reacted after 6 days.

We performed an ultrasound and discovered that basically all his internal organs were compromised. He has severe alterations everywhere. Still, the best specialists I could find couldn’t tell me what was causing it and offer a course of treatment that didn’t involve opening him up to collect tissues for a biopsy.

I personally think it is absurd that a doctor could look at this frail elderly cat who obviously can’t resist anesthesia without serious risks and say that surgery is the only way to go, all to find out for sure if we’re dealing with a lymphoma or an infection. I’m looking for someone to advise me on the most effective course of action. Of course, I aim to reverse his condition, but I understand that given his age and how advanced it is, it might not be an option.

He is currently at 3kg, eating exclusively Royal Canin Gastrointestinal Hydrolyzed Protein with fish oil, and taking prednisolone every day for a month now. His appetite is healthy, he still drinks a lot, pees a lot, and poops regularly but softer. He eats an average of 5 small meals.
Vomits are back down to a few times a week, usually early in the morning before his first meal, and always a clear liquid. He goes and eats right after throwing up so I get the impression he is not nauseous.
He doesn’t seem to be in pain overall.
He’s not gaining any weight regardless of all my efforts.

That is why I’m giving this a shot and trying to get your attention. I hope you have more resources and knowledge that could help me figure out appropriate next steps to give this little guy the best fighting chances I can.

On this link you’ll find a translation of his bloodwork and ultrasound. I had chat GPT translate it for me so forgive me if there are errors.
Link: https://docs.google.com/document/d/1yqcen-TYzyvfBYU-J4t1tCHola1E2otDGDa1H7V032Y

I appreciate any support you can lend me, his name is Valentim which means brave and strong, and I want him to win this fight.

Hi! We’ve adopted an old cat who was previously a stray, he has hyperthyroidism and is underweight (6.5 pounds at last vet checkup a month ago). He’s been getting better in most aspects (his labs are normal now, no FIV, etc), but he’s been fighting ringworm consistently since January. We’ve done regular rounds of lime sulfur dip, miconazole spray and baths, and pretty constant environmental spore cleaning (regular laundry, Rescue antifungal spray, cleaning/vacuuming) for 2 months but he keeps picking it back up. We’ve been UV lighting him often, and when it finally seems to be going away a new spot pops up!! Any tips? We were initially discouraged from getting the prescription oral antifungal med for him due to his health fragility at first, but with his labs more normal and a higher weight would the systemic medication help?

My cat was recently diagnosed with hyperthyroidism. The research I’ve done so far suggests that radio iodine therapy is the best course of action. There are 2 practices that provide this treatment; Radiocat in Catonsville, MD & Mid Atlantic Feline Thyroid Center in Queenstown, MD. I’m trying to determine which practice would be best for our cat. I already know one of them does not have availability until early June, but I don’t want that to be the deciding factor.

Hi, my cat was diagnosed with hyperthyroidism about 2 weeks ago and our vet put her on Methimazole 5 mg liquid. Yesterday my cat started trying to urinate frequently (every couple of minutes) and defecated outside of her letterbox several times. I searched up to see if these were the symptoms of the medication and was unable to find anything online. So i just wanted to run it by you guys and double check. Today my cat seems to be doing well, she is not urinating every few minutes, however, I’m still a little worried. Thanks so much!

Hi Dr. Magnifico. We took Boogie to VRA in Gaithersburg, MD, a couple weeks ago, hoping to have the Radioactive Iodine Therapy done for his hyperthyroidism, but Dr. Conway said she did not think he was a good candidate for it and was very concerned with his constipation.

She did bloodwork, an ultrasound, chest x-rays and more. We took him there on 4/16 and again on 4/27. I asked her to send all results to you and I hope you have received them by now.
Dr. Conway said he has a tumor or mass on his kidney but no abnormalities found from the chest x-ray.
She quoted me $5,000-$6,000 (gulp) to do the surgery, but I can not remember if she said that was to remove the tumor from the kidney, or remove the entire kidney.
She also mentioned something about his blood being thicker? I really can not remember exactly what she said about that, but it didn’t sound good. It may have something to do with his red blood cell level being high due to the tumor on his kidney.

She said to cut back his methimazole to 1/2 pill every 12 hours. *Dr. Conway told me that his hyperthyroidism is very mild.
She also said raise his dose of cisapride 5 mg/ml from 1 ml every 12 hours to 1 ml every 8 hours (three times a day), and she said to raise his dose of lactulose to 3 ml every 8 hours.
I started all of the above on 4/17.

He has since sprained his leg and is limping. He’s been hiding under the bed more, but not completely. He will still come up on the bed to visit me once or twice a day, but just not as often as he used to, and is still coming up on the bed to sleep with me. I’m not sure if he’s not feeling well because of Dr. Conways findings, because of his sprained leg, or both, the reason he is under the bed more.

Here is the last email I received from Dr. Conways office on 4/29, after his ultrasound on 4/27:

1) His calcium results was fine and within normal limits. Dr. Conway suspects the prior calcium elevated was due to lab error.
2) His thyroid level is good on the lower dose of Methimazole – please continue as directed with this medication.
3) His blood cell count shows his red blood cell level is HIGHER – this is due to the tumor of his kidney. If you are not interested in pursuing surgery for Boogie, Dr. Conway’s recommendation would be an oncology consult to discuss any palliative care options.

Please let me know if you have any questions.
​
Julia Conny, RVT
Internal Medicine Lead Technician
Veterinary Referral Associates
301-926-3300

Dr. Mag, We have been clients of yours for several years, as four of our cats are all seen by you and your wonderful staff. We are begging you on hands and knees to please help our Boogie boy. He is only 12 years old and we are not ready for him to go. Can you please do the removal of the tumor or kidney? We realize it is a very risky surgery, but we would feel better knowing we did something, than not. We know you are a big advocate of doing everything you can to help bring pets back to health, instead of just giving up.
I’m in tears as I write this. Can you please look at all his records you have at your office asap, and also what Dr. Conways office sent you. Please, can you help our baby?

Terri and Steve

Hello, I have a kitty Cheesey poof who is on methimazole for hyperthyroidism. My question is has anyone used herbs or homeopathy for this condition instead? And what has worked succesfully? Thanks

Hi Dr. Magnifico. Our cat Boogie was recently seen by Dr. Ahrens for his constipation issues, and also to have blood drawn to check his hyperthyroidism. I have a couple questions for Dr Ahrens.
I prefer not calling the office, as I do not want to pull her away from whatever she is doing at that time, and it is really hard to reach me by phone.
Can you please ask her to email me at ——— or if you could give me her JVC email address so I can email her, I would greatly appreciate it!
Thank you!
Terri